A pulse-racing tale of biotech bug fixing

The US Food and Drug Administration (FDA) is advising health professionals to keep an eye on some of the equipment they use to monitor pacemakers and other heart implants.

The watchdog's alert this week comes after Irish medical device maker Medtronic said it will lock some of its equipment out of its software update service, meaning the hardware can't download and install new code from its servers.

That may seem counterintuitive, however, it turns out security vulnerabilities in its technology that it had previously thought could only be exploited locally could actually be exploited via its software update network. Malicious updates could be pushed to Medtronic devices by hackers intercepting and tampering with the equipment's internet connections – the machines would not verify they were actually downloading legit Medtronic firmware – and so the biz has cut them off.

To get the latest patches, the software will have to be installed by hand via USB by a Medtronic technician. Both the FDA and Medtronic said there is no immediate danger to any patients or doctors.

The security bugs are not present in the implants themselves, but rather in Medtronic "programmers," which doctors and medics connect to patients' implants during and after surgery, allowing them to check battery levels, monitor heart rhythms, and adjust any settings.

Fatal flaws in ten pacemakers make for Denial of Life attacks

Two models, the Carelink 2090 and the Carelink Encore 2091, could have been tampered with by an attacker modifying their firmware and, in turn, change how the programmers configured the implants. Medtronic said that now not only does it believe those vulnerabilities would be locally exploitable, but could also be targeted by an attacker who was able to remotely access the device.

"Although the programmer uses a virtual private network (VPN) to establish an internet connection with the Medtronic [software distribution network] SDN, the vulnerability identified with this connection is that the programmers do not verify that they are still connected to the VPN prior to downloading updates," the FDA explained.

"To address this cybersecurity vulnerability and improve patient safety, on October 5, 2018, the FDA approved Medtronic's update to the Medtronic network that will intentionally block the currently existing programmer from accessing the Medtronic SDN."

As a result, Medtronic said, it has cut both device models' access to the SDN, meaning the only way for hospitals and clinics to get firmware updates will be on-site by Medtronic techs. In the meantime, the FDA said the devices will continue to operate as normal and no immediate action needs to be taken.

In short, nobody's pacemaker is getting hacked any time soon, and doctors and patients have nothing to worry about, but updating the programmers is going to be a bit of a pain. ®